NU 217
Gerontological Nursing
Final Exam Review
(Questions & Solutions)
2025
1
,1. An 80-year-old patient has a serum creatinine of 1.2 mg/dL but
reduced muscle mass. Which calculation best estimates renal function in
this patient?
A. Cockcroft–Gault equation using actual body weight
B. MDRD formula without adjustment
C. Creatinine clearance via 24-hour urine collection
D. eGFR based solely on serum creatinine
Correct ANS: C
Rationale: In frail elders with low muscle mass, 24-hour creatinine
clearance provides a more accurate estimate of glomerular filtration than
equations relying on serum creatinine.
2. A frail older adult’s medication list includes diphenhydramine. Which
adverse effect is most concerning given age-related pharmacodynamics?
A. Hypotension
B. Extrapyramidal symptoms
C. Anticholinergic delirium
D. Neutropenia
Correct ANS: C
Rationale: Older adults are highly sensitive to anticholinergic drugs,
which can precipitate acute confusion and delirium.
3. An 85-year-old with sudden onset confusion is disoriented to time and
place. Family reports normal cognition last week. Which diagnosis is most
likely?
A. Alzheimer dementia
B. Vascular dementia
C. Delirium
D. Lewy body dementia
2
, Correct ANS: C
Rationale: Delirium is characterized by acute onset, fluctuating
consciousness, and impaired attention, unlike chronic dementias.
4. A resident in a long-term care facility becomes more agitated each
evening. What nonpharmacologic intervention is best to manage this
sundowning behavior?
A. Administer nightly haloperidol
B. Increase ambulation and bright lighting in late afternoon
C. Restrict fluid intake after 6 pm
D. Provide daytime naps
Correct ANS: B
Rationale: Maximizing daytime activity and environmental illumination
helps normalize circadian rhythms and reduce evening agitation.
5. A geriatric nurse assesses fall risk. Which factor is strongest predictor
for future falls?
A. Polypharmacy (> 5 drugs)
B. History of falls in past year
C. Mild cognitive impairment
D. Use of compression stockings
Correct ANS: B
Rationale: Prior falls history is the single most reliable predictor of
subsequent falls in older adults.
6. A pressure ulcer risk assessment yields a Braden score of 12. What
does this indicate?
A. No risk
B. Mild risk
C. Moderate risk
D. High risk
Correct ANS: C
3
Gerontological Nursing
Final Exam Review
(Questions & Solutions)
2025
1
,1. An 80-year-old patient has a serum creatinine of 1.2 mg/dL but
reduced muscle mass. Which calculation best estimates renal function in
this patient?
A. Cockcroft–Gault equation using actual body weight
B. MDRD formula without adjustment
C. Creatinine clearance via 24-hour urine collection
D. eGFR based solely on serum creatinine
Correct ANS: C
Rationale: In frail elders with low muscle mass, 24-hour creatinine
clearance provides a more accurate estimate of glomerular filtration than
equations relying on serum creatinine.
2. A frail older adult’s medication list includes diphenhydramine. Which
adverse effect is most concerning given age-related pharmacodynamics?
A. Hypotension
B. Extrapyramidal symptoms
C. Anticholinergic delirium
D. Neutropenia
Correct ANS: C
Rationale: Older adults are highly sensitive to anticholinergic drugs,
which can precipitate acute confusion and delirium.
3. An 85-year-old with sudden onset confusion is disoriented to time and
place. Family reports normal cognition last week. Which diagnosis is most
likely?
A. Alzheimer dementia
B. Vascular dementia
C. Delirium
D. Lewy body dementia
2
, Correct ANS: C
Rationale: Delirium is characterized by acute onset, fluctuating
consciousness, and impaired attention, unlike chronic dementias.
4. A resident in a long-term care facility becomes more agitated each
evening. What nonpharmacologic intervention is best to manage this
sundowning behavior?
A. Administer nightly haloperidol
B. Increase ambulation and bright lighting in late afternoon
C. Restrict fluid intake after 6 pm
D. Provide daytime naps
Correct ANS: B
Rationale: Maximizing daytime activity and environmental illumination
helps normalize circadian rhythms and reduce evening agitation.
5. A geriatric nurse assesses fall risk. Which factor is strongest predictor
for future falls?
A. Polypharmacy (> 5 drugs)
B. History of falls in past year
C. Mild cognitive impairment
D. Use of compression stockings
Correct ANS: B
Rationale: Prior falls history is the single most reliable predictor of
subsequent falls in older adults.
6. A pressure ulcer risk assessment yields a Braden score of 12. What
does this indicate?
A. No risk
B. Mild risk
C. Moderate risk
D. High risk
Correct ANS: C
3
